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Dr. John Kress: The statistical probability is that it's bacterial, although it certainly could be viral pneumonia. It's difficult to get an actual diagnosis, though [doctors] can do something called a bronchoscopy. But if she's not in the hospital, she's not getting a bronchoscopy. Given that, it would have to be sputum [that they're using for a diagnosis], which they would send to a lab to try to identify an organism, though many times the samples don't disclose a particular organism.
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Coughing up mucus from the lungs, which often is green or yellowish in color. Some patients can produce a lot of sputum, and some can't. It's related to how strong the person is and her ability to generate a vigorous cough. It might also be that some pneumonias are more inclined to lead to substantial sputum production and some aren't.But in either case, would it be normal to provide antibiotics?
Usually we're going to give what are called empiric antibiotics. That is, we'd treat the common causes of pneumonia. I don't know if she's on medications that suppress her immune system. If not, it would probably be a standard, community-acquired-pneumonia treatment.Some publications call this "walking pneumonia." What's that?
The term refers to the patient being ambulatory as opposed to in the hospital. It's kind of an old term, but it basically means you aren't hospitalized. The medical term would be "community-acquired pneumonia." Many patients with community-acquired pneumonia are treated without being hospitalized.How would that cause a patient to faint?
It depends. If she's otherwise healthy and has no heart problems, then the coughing could lead to fainting just by virtue of the vigor with which the person coughs. That can actually tangibly impede blood flow back to the heart and make you dizzy. She might be dehydrated if she has bad pneumonia. There are a lot of things that could be in play there. Obviously if she has underlying heart disease [that would be a factor].At 68, it's probably safe to call Clinton "elderly." Is her age a big red flag when it comes to pneumonia?
I've definitely seen the term "elderly" changing year by year. Some doctors would describe that as elderly, but probably not. But she certainly isn't 21, how about that? And a middle-aged person could have trouble with vigorous coughing; in conjunction with dehydration and fevers, and that kind of thing, that could certainly lead to this type of problem. But assuming she doesn't have chronic illnesses, and isn't on medication that suppresses her immune system, I'd say the statistical probability for her recovery is pretty good.Could a pneumonia diagnosis be a reflection of poor overall health?
This condition—assuming all the information about it is truthful—is not something that, by virtue of it happening, would likely result in a difficult road ahead, unlike a stroke, for example, or a heart attack or a seizure. If I were to reach into the magic hat, and pull out "heart attack," "stroke," "cancer," "seizure," or "community-acquired pneumonia," I'd be happy to get the community-acquired pneumonia.Follow Mike Pearl on Twitter.